12 September 2023

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Core oral health outcomes for sports dentistry research

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Introduction and background

Core outcome sets (COS) are standardized sets of outcomes for research of a particular condition or intervention typically developed by consensus among the research stakeholders. They represent the minimum collection of measures that should be recorded and reported. The aim is to standardize both what is assessed, the outcome, and how it is assessed to enable synthesis of multiple studies.

The premise is to use research data more efficiently and effectively. Ethically, it is our responsibility that research involving human participants has the greatest likelihood of informing on improvements to health and well-being. It is also worth emphasizing that screening for oral conditions is recommended as beneficial for health for both the general population and for athletes.

High-quality data on the prevalence and impact of health-related incidents are important to establish the burden of health problems and inform appropriate preventive and health promotion strategies, and the International Olympic Committee has called for more accurate data on oral health.

The aim of this paper is to propose a core outcome set for sports dentistry research, based on those that we have developed over several years, to initiate debate and discussion leading to a consensus.

Elite athletes at risk

Sports dentistry has traditionally focused on epidemiology and prevention of orofacial trauma. However, there is increasing evidence that exercise training and competition, particularly at the elite level, may significantly increase the risk to oral health of athletes.

Elite athletes tend to be in the age group most commonly associated with eruption of third molars and related problems. Tooth decay, erosive tooth wear and trauma to the teeth all cause irreversible damage, as does the dental treatment required to manage these conditions, which also carries a lifetime cost. The feelings that people perceive from their body can provide a summation of their physical condition, underlying mood and emotional state. Therefore, athlete self-reports of symptoms and performance impacts should be included as an essential part of data collection frameworks.

There is a wealth of literature demonstrating impacts of oral diseases, including caries, periodontal diseases and pericoronitis, on the quality of life. With clear psychosocial impacts of oral health, it would be surprising if training and performance were not affected in those athletes with poor oral health. It is also important for athletes to understand possible risks of an athletic lifestyle and strategies to mitigate those risks.

Ideally, the indices used to collect clinical data should be easy to use, evidence-based and applicable in a wide variety of settings and enable comparability with epidemiologic data. The Adult Dental Health Surveys (ADHS) have been carried out in the UK every 10 years since 1968 and provide an established model for clinical outcomes, self-reported psychosocial impacts, oral health behaviors and risks to oral health.

A systematic review identified an athlete-reported outcome measure of impact on performance with validity for use in sport, which could be adapted for oral health problems.

Julie Gallagher, Paul Ashley, Ian Needleman, "Core Oral Health Outcomes for Sports Dentistry Research," International Dental Journal, 4 September 2023, ISSN 0020-6539, https://doi.org/10.1016/j.identj.2023.07.014.